The Patient Protection and Affordable Care Act (ACA) is being credited for a slight shift to earlier diagnosis for patients with three major cancers, according to a study being presented next month at the American Society of Clinical Oncology (ASCO) meeting in Chicago.
Researchers from the American Cancer Society examined the number of stage I diagnoses for a variety of major cancers, including breast, cervical, colorectal, prostate, and lung. Their hypothesis was that the availability of health insurance might prompt individuals to seek out screening services that might detect cancers earlier.
Indeed, the researchers found a small but statistically significant increase in stage I disease for three of the cancers from before the ACA went into effect (the first nine months of 2013) to after it was implemented (the last nine months of 2014), in nonelderly cancer patients of screening-appropriate age. They calculated stage I cancer diagnoses as a percentage of overall diagnoses, categorizing them by type of cancer.
Of the five diseases, breast, colorectal, and lung cancer showed a statistically significant shift to earlier diagnosis; the shift demonstrated by cervical cancer was not statistically significant. Prostate cancer showed a decline in earlier diagnoses, which the authors attributed to a change in guidelines for prostate cancer screening by the U.S. Preventive Services Task Force (USPSTF).
| Percent of stage I cancer diagnoses before and after ACA | ||
| Before ACA | After ACA | |
| Breast | 47.8% | 48.9% |
| Cervical | 47.2% | 48.7%* |
| Colorectal | 22.8% | 23.7% |
| Lung | 16.6% | 17.7% |
| Prostate | 18.5% | 17.2% |
"The implementation of the ACA is associated with a shift to early stage at diagnosis for all screenable cancers except prostate cancer, which may reflect the recent U.S. Preventive Services Task Force recommendations against routine prostate cancer screening," the authors concluded in their abstract.
